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(American Journal of Pathology. 2001;158:647-654.)
© 2001 American Society for Investigative Pathology

Regular Article

Helicobacter pylori Genotypes May Determine Gastric Histopathology

Cristina Nogueira*{ddagger}, Céu Figueiredo*{dagger}{ddagger}, Fátima Carneiro*{dagger}, António Taveira Gomes§, Raul Barreira§, Paulo Figueira§, Céu Salgado§, Luis Belo{ddagger}, António Peixoto*, Juan C. Bravo||, Luis E. Bravo||, Jose L. Realpe**, Anton P. Plaisier**, Wim G. V. Quint{ddagger}, Bernardo Ruiz{dagger}{dagger}, Pelayo Correa{dagger}{dagger} and Leen-Jan van Doorn{ddagger}

From the Institute of Molecular Pathology and Immunology *
and the Faculty of Medicine,{dagger}
University of Porto, Porto, Portugal; the Delft Diagnostic Laboratory,{ddagger}
Delft, The Netherlands; Hospital de S. João,§
Porto, Portugal; ENVC,{ddagger}
Viana do Catelo, Portugal; the Universidad del Valle,||
Cali, Colombia; the Medical Faculty,**
Department of Public Health, Erasmus University Rotterdam, Rotterdam, The Netherlands; and the Department of Pathology,{dagger}{dagger}
Louisiana State University, New Orleans, Louisiana

The outcome of Helicobacter pylori infection has been associated with specific virulence-associated bacterial genotypes. The present study aimed to investigate the gastric histopathology in Portuguese and Colombian patients infected with H. pylori and to assess its relationship with bacterial virulence-associated vacA, cagA, and iceA genotypes. A total of 370 patients from Portugal (n = 192) and Colombia (n = 178) were studied. Corpus and antrum biopsy specimens were collected from each individual. Histopathological features were recorded and graded according to the updated Sydney system. H. pylori vacA, cagA, and iceA genes were directly genotyped in the gastric biopsy specimens by polymerase chain reaction and reverse hybridization. Despite the significant differences between the Portuguese and Colombian patient groups, highly similar results were observed with respect to the relation between H. pylori genotypes and histopathology. H. pylori vacA s1, vacA m1, cagA+ genotypes were significantly associated with a higher H. pylori density, higher degrees of lymphocytic and neutrophilic infiltrates, atrophy, the type of intestinal metaplasia, and presence of epithelial damage. The iceA1 genotype was only associated with epithelial damage in Portuguese patients. These findings show that distinct H. pylori genotypes are strongly associated with histopathological findings in the stomach, confirming their relevance for the development of H. pylori-associated gastric pathology.




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